Though sigmoid volvulus is a common cause of bowel obstruction, it may be challenging in decision making and management at high altitude as well in a resource limited setup. In this case report, we present a case of young male in high altitude presented with recurrent sigmoid volvulus with impending perforation, managed surgically, and have discussed about the challenges of surgical management of such cases in resource limited high altitude setup and dealing with decisional dilemma on conservative vs surgical management.
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